National Health Insurance Act

The national government, prefectures, Municipalities and Societies, and health insurance-covered medical institutions, etc. and other persons involved are to cooperate with each other while collaborating mutually, through the introduction of an electronic eligibility confirmation mechanism and other promotion of the use of information and communications technology in procedures, so that affairs carried out under the provisions of the respective Acts on medical insurance, etc. (meaning the respective Acts on medical insurance prescribed in Article 7, paragraph (1) of the Act on Assurance of Medical Care for Elderly People and the Act on Assurance of Medical Care for Elderly People) and other laws and regulations that provide for benefits relating to medical care are implemented smoothly.

When the Minister of Health, Labour and Welfare or a prefectural governor finds it necessary in relation to an insurance benefit, said minister or governor may order any physician, dentist, pharmacist or midwife or any person who gave treatment or any person who employs any of the above to make a report or present medical records, birth records, the books and other documents or any other article, or may have personnel question any of the above persons, regarding the medical care or medication or treatment, or delivery care, provided by the relevant person.

When the Minister of Health, Labour and Welfare or the prefectural governor finds it necessary, said minister or governor may order a current or former insured person who received payment of benefits for medical treatment or expenses for Dietary Treatment for inpatients, expenses for Living Support for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses for home-nursing, special medical expenses or delivery expenses to make a report or may have personnel question such insured person, regarding the content of the medical care, preparation of drugs, designated home nursing or delivery care relevant to the payment of said benefit for medical treatment or said expenses for Dietary Treatment for inpatients, expenses for Living Support for inpatients, medical expenses combined with treatment outside insurance coverage, medical expenses for home-nursing, special medical expenses or delivery expenses.

The provisions of Article 106, paragraph (2) and those of Article 106, paragraph (3) shall apply mutatis mutandis to questions asked and the authority granted, respectively, pursuant to the provisions of Article 113 and the preceding Article.

An insured person who is domiciled within the area of one Municipality in order to attend school and who would, if said person did not so attend school, be found to belong to the same household as another person who is domiciled within the area of another Municipality shall be deemed, for the purpose of the application of this Act, to be domiciled within the area of the other Municipality and to belong to said household.

An insured person who is found to have changed domicile, as a result of the hospitalization, admission or residence listed in the following items (hereinafter referred to as "hospitalization, etc." in this Article), to the location of the hospital, clinic or institution prescribed in those items (hereinafter referred to as "hospital, etc." in this Article), and who is found to have been domiciled within the area of another Municipality (meaning a Municipality other than the Municipality in which that hospital, etc. is located) when hospitalized, etc. in that hospital, etc., is deemed, for the purpose of the application of this Act, to be domiciled within the area of the other Municipality; provided, however, that this does not apply to an insured person who has been hospitalized, etc. continuously in two or more hospitals, etc. and who is found to have changed domicile sequentially to the location of the hospital, etc. in which the person was hospitalized, etc. immediately before being hospitalized, etc. in the hospital, etc. in which the person is currently hospitalized, etc. (hereinafter referred to as the "current hospital, etc." in this Article) (hereinafter referred to as the "last hospital, etc." in this paragraph) and then to that of the current hospital, etc., as a result of being hospitalized, etc. in each of the last hospital, etc. and the current hospital, etc. (referred to as a "specified continuously hospitalized insured person" in the following paragraph).

hospitalization or admission to a clinic;

admission to a child welfare institution as set forth in Article 7, paragraph (1) of the Child Welfare Act (Act No. 164 of 1947) (limited to cases where admission measures are taken pursuant to the provisions of Article 27, paragraph (1), item (iii) or Article 27-2 of the same Act);

admission to a support facility for persons with disabilities prescribed in Article 5, paragraph (11) of the Act on Providing Comprehensive Support for the Daily Life and Life in Society of Persons with Disabilities (Act No. 123 of 2005) or a facility specified by order of the competent ministry prescribed in paragraph (1) of that Article;

admission to the facilities established by the Nozominosono National Center for Persons with Severe Intellectual Disabilities Incorporated Administrative Agency, pursuant to the provisions of Article 11, item (i) of the Act for the Nozominosono National Center for Persons with Severe Intellectual Disabilities Incorporated Administrative Agency (Act No. 167 of 2002);

admission to a nursing home for the elderly or an intensive care home for the elderly as set forth in Article 20-4 or Article 20-5, respectively, of the Public Aid for the Aged Act (Act No. 133 of 1963) (limited to cases where admission measures are taken pursuant to the provisions of Article 11, paragraph (1), item (i) or (ii) of the same Act);

Among specified continuously hospitalized insured persons, those listed in the following items are deemed, for the purpose of the application of this Act, to be domiciled within the area of the Municipality specified in the relevant item.

an insured person whose domicile is, due to the fact that said person was Hospitalized, etc. in two or more Hospitals, etc. continuously, found to have been sequentially changed to the locations of the respective Hospitals, etc. and who is found to have been domiciled in the area of another Municipality (meaning any Municipality other than that in which the Current Hospital, etc. is located) at the time when said person was Hospitalized, etc. in the first of such two or more Hospitals, etc.: said other Municipality;

an insured person whose domicile is, in association with the fact that said person was Hospitalized, etc. in one of the two or more Hospitals, etc. in which said person has been continuously hospitalized into another Hospital, etc. with no break (hereinafter referred to as "Continuous Hospitalization, etc." in this item), found to have been changed from a place other than the location of said Hospital, etc. to the location of said other Hospital, etc. (hereinafter referred to as "Specified Change of Domicile" in this item) and who is found to have domiciled in the area of another Municipality (meaning any Municipality other than that in which the Current Hospital, etc. is located) at the time of the most recent Specified Change of Domicile: said another Municipality.

A hospital, etc. in which an insured person to whom the provisions of the preceding two paragraphs apply is under hospitalization, etc. must provide necessary cooperation to the Municipality in which such hospital, etc. is located and the Municipality within the area of which that insured person is deemed, pursuant to the provisions of the preceding two paragraphs, to be domiciled.

In this Act, the term "a prefectural governor" or "the prefectural governor" shall be deemed to be replaced with "the Minister of Health, Labour and Welfare" in the case of a Federation whose district extends over the area of two or more prefectures.

The authority of the Minister of Health, Labour and Welfare provided for in this Act may be delegated to the Director-General of the relevant Regional Bureau of Health and Welfare pursuant to the provisions of Ordinance of the Ministry of Health, Labour and Welfare.

The authority delegated to the Director-General of such Regional Bureau of Health and Welfare pursuant to the provisions of the preceding paragraph may be delegated to the Director-General of the relevant Regional Branch Bureau of Health and Welfare pursuant to the provisions of Ordinance of the Ministry of Health, Labour and Welfare.

When the Minister of Health, Labour and Welfare or a prefectural governor conducts any of the affairs specified in Article 41, paragraph (1) (including cases where applied mutatis mutandis pursuant to Article 52, paragraph (6), Article 52-2, paragraph (3), Article 53, paragraph (4) and Article 54-3, paragraph (7)) and paragraph (2) (including cases where applied mutatis mutandis pursuant to Article 45-2, paragraph (4), Article 52, paragraph (6), Article 52-2, paragraph (3), Article 53, paragraph (4) and Article 54-3, paragraph (7)), Article 45-2, paragraph (1) (including cases where applied mutatis mutandis pursuant to Article 52, paragraph (6), Article 52-2, paragraph (3), Article 53, paragraph (4) and Article 54-3, paragraph (7)), Article 54-2-2 (including cases where applied mutatis mutandis pursuant to Article 54-3, paragraph (7)), Article 54-2-3, paragraph (1) (including cases where applied mutatis mutandis pursuant to Article 54-3, paragraph (7)), Article 54-7, paragraph (1), paragraph (2) of that Article (including cases where applied mutatis mutandis pursuant to Article 54-8, paragraph (2)), Article 54-8, paragraph (1) and Article 114 pursuant to these provisions, the relevant affairs shall be conducted under mutually close coordination.

The affairs which shall be handled by a prefecture pursuant to the provisions of Article 17, paragraph (1) and paragraph (3) (including cases where applied mutatis mutandis pursuant to Article 27, paragraph (3)), Articles 24-4 and 24-5, Article 25, paragraph (1), Article 27, paragraphs (2) and (4), Article 32, paragraph (2), Article 32-2, paragraph (2), Article 32-7, paragraph (1) and paragraph (2) (including cases where applied mutatis mutandis pursuant to paragraph (3) of the same Article), Article 32-12, Article 41, paragraph (1) (including cases where applied mutatis mutandis pursuant to Article 52, paragraph (6), Article 52-2, paragraph (3), Article 53, paragraph (4) and Article 54-3, paragraph (7)) and paragraph (2) (including cases where applied mutatis mutandis pursuant to Article 45-2, paragraph (4), Article 52, paragraph (6), Article 52-2, paragraph (3), Article 53, paragraph (4) and Article 54-3, paragraph (7)), Article 45, paragraph (3) and Article 45-2, paragraphs (1) and (5) (including cases where these provisions shall apply mutatis mutandis pursuant to Article 52, paragraph (6), Article 52-2, paragraph (3), Article 53, paragraph (4) and Article 54-3, paragraph (7)), Article 54-2-2 and Article 54-2-3, paragraphs (1) and (3) (including cases where these provisions shall apply mutatis mutandis pursuant to Article 54-3, paragraph (7)), Article 54-7, paragraph (1), paragraph (2) of that Article (including cases where applied mutatis mutandis pursuant to Article 54-8, paragraph (2)), Article 54-8, paragraphs (1) and (3), Article 80, paragraph (1), Article 88 and Article 89, paragraph (1), the affairs which shall be handled by a prefecture pursuant to the provisions of Article 106, paragraph (1) (limited to the part relating to item (ii)), Article 107 (limited to the part relating to item (ii)) and Article 108 and which are relevant to a Society, and the affairs which shall be handled by a prefecture pursuant to the provisions of Article 114 shall be Type 1 statutory entrusted functions as prescribed in Article 2, paragraph (9), item (i) of the Local Autonomy Act.

Unless otherwise specially provided for in this Act, procedures for the enforcement of this Act and other detailed regulations necessary for the execution thereof shall be prescribed by Ordinance of the Ministry of Health, Labour and Welfare.